Abstract
This multicentre study was aimed at comparing the trough effect of telmisartan and perindopril on diastolic blood pressure (DBP), using self blood pressure measurement (SBPM). A second objective was to compare the data obtained from SBPM with those provided by automatic office BP measurement. A total of 441 mild-to-moderate hypertensive patients were randomised to receive either telmisartan 40 mg or perindopril 4 mg for a period of 12 weeks. Patients whose clinic DBP remained higher than or equal to 90 mmHg at the end of the 6th week (W6) were given a double-dose regimen. Office BP and SBPM were performed at baseline (W0), at W6 and at week 12 (W12), both with the same automatic device. A greater diminution of trough DBP was obtained with telmisartan (−6.6±6.7 mmHg) than with perindopril (−5.1±7.0 mmHg; P=0.018). Regarding clinic BP, the same results were observed. Doubling dose was significantly less frequent with telmisartan (41%; n=85) than with perindopril (55%; n=115, P=0.005). Mean values of SBPM were lower than office BP values, with a difference of a greater importance at W0 than at W12: 6.6 vs 4.7 mmHg for systolic blood pressure (P<0.005) and 3.2 vs 1.4 mmHg for DBP (P<0.0001). At W12, isolated office hypertension was found in 9% of the patients (n=37), while there were 14% of the patients (n=55) with isolated home hypertension. In conclusion, the trough effect on DBP was statistically higher with telmisartan than with perindopril. SBPM values were lower than office BP values, with greater differences before than after treatment. About a quarter of the patients were found to be controlled with a method but not with the other one.
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References
Abe H et al. Relation of office and home blood pressure to left ventricular hypertrophy and performance in patients with hypertension High Blood Press 1992 1: 279–285
Ohkubo T et al. Home blood pressure measurement has a stronger predictive power for mortality than does screening blood pressure measurement: a population-based observation in Ohasama, Japan J Hypertens 1998 16: 971–975
Nesbitt SD et al. Home blood pressure as a predictor of future blood pressure stability in borderline hypertension. The Tecumseh study Am J Hypertens 1997 10: 1270–1280
James JD, Pickering TG, Yees LS . Reproducibility of average ambulatory, home and clinic pressures Hypertension 1998 11: 545–549
Sakuma M et al. Reproducibility of home blood pressure measurements over a one-year period Am J Hypertens 1997 10: 798–803
Carnahan JE, Nugent CA . The effects of self-monitoring by patients on the control of hypertension Am J Med Sci 1975 269: 69–73
Zarnke K, Feagan B, Mahon J, Feldman RD . A randomized study comparing a patient-directed hyper-tension management strategy with usual office-based care Am J Hypertens 1997 10: 58–67
Edmonds D et al. Does self-measurement of blood pressure improve patient compliance in hypertension? J Hypertens 1985 3 (Suppl) S31–S34
Pickering T . Recommendations for the use of home (self) and ambulatory blood pressure monitoring. American Society of Hypertension Ad Hoc Panel Am J Hypertens 1996 9: 1–11
Soghikan K et al. Home blood pressure monitoring: effect on use of medical services and medical care costs Med Care 1992 30: 855–865
O'Brien E, Mee F, Atkins N, Thomas M . Evaluation of three devices for self-measurement of blood pressure according to the revised British Hypertension Society Protocol: the Omron HEM-705CP, Philips HP5332, and Nissei DS-175 Blood Press Monit 1996 1: 55–61
Asmar R, Zanchetti A . Guidelines for the use of self-blood pressure monitoring: a summary report of the First International Consensus Conference. Groupe Evaluation & Measure of the French Society of Hypertension J Hypertens 2000 18: 493–508
Bland JM, Altman DG . Statistical methods for assessing agreement between two methods of measurement Lancet 1986 I: 307–310
Neutel JM et al. Comparison of telmisartan with lisinopril in patients with mild-to-moderate hypertension Am J Ther 1999 6: 161–166
Smith DH, Matzek KM, Kempthorne-Rawson J . Dose response and safety of telmisartan in patients with mild to moderate hypertension J Clin Pharmacol 2000 40: 1380–1390
Smith DH, Neutel JM, Morgenstern P . Once daily telmisartan compared with enalapril in the treatment of hypertension Adv Ther 1998 15: 229–240
Neutel JM, Smith DH, Reilly PA . The efficacy and safety of telmisartan compared to enalapril in patients with severe hypertension Int J Clin Pract 1999 53: 175–178
Karlberg BE, Lins LE, Hermansson K . Efficacy and safety of telmisartan, a selective AT1 receptor antagonist, compared with enalapril in elderly patients with primary hypertension. TEES Study Group J Hypertens 1999 17: 293–302
Mallion JM, Siché JP, Lacoucière Y the Telmisartan Blood Pressure Monitoring Group. ABPM comparison of the antihypertensive profiles of the selective angio-tensin II receptor antagonists telmisartan and losartan in patients with mild-to-moderate hypertension J Hum Hypertens 1999 13: 657–664
Lacourcière Y et al. A comparison of the efficacy and duration of action of the angiotensin II receptor blocker telmisartan to amlodipine Blood Press Monit 1998 3: 295–302
Lacourcière Y et al. Efficacy and tolerability of a fixed-dose combination of telmisartan plus hydrochlorothiazide in patients uncontrolled with telmisartan monotherapy J Hum Hypertens 2001 15: 763–770
Dickerson JE et al. Optimisation of antihypertensive treatment by crossover rotation of four major classes Lancet 1999 353: 2008–2013
Ragot S, Genes N, Vaur L, Herpin D . Comparison of three blood pressure measurement methods for the evaluation of two antihypertensive drugs: feasibility, agreement, and reproducibility of blood pressure response Am J Hypertens 2000 13: 632–639
Brook RD . Home blood pressure: accuracy is independent of monitoring schedules An J Hypertens 2000 13: 625–631
Kjeldsen SE et al. Hypertension optimal treatment (HOT) study. Home blood pressure in treated hypertensive subjects Hypertension 1998 31: 1014–1020
Parati G, Omboni S, Mancia G . Difference between office and ambulatory blood pressure and response to antihypertensive treatment J Hypertens 1996 14: 791–797
Ima Y et al. Usefulness of home blood pressure measurements in assessing the effect of treatment in a single-blind placebo-controlled open trial J Hypertens 2001 19: 179–185
Bobrie G et al. Is isolated home hypertension as opposed to isolated office hypertension a sign of greater cardiovascular risk? Arch Intern Med 2001 161: 2205–2211
Karlberg BE, Lins LE, Hermansson K for the TEES Study Group. Efficacy and safety of telmisartan, a selective AT1 receptor antagonist, compared with enalapril in elderly patients with primary hypertension J Hypertens 1999 17: 293–302
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Ragot, S., Ezzaher, A., Meunier, A. et al. Comparison of trough effect of telmisartan vs perindopril using self blood pressure measurement: EVERESTE study. J Hum Hypertens 16, 865–873 (2002). https://doi.org/10.1038/sj.jhh.1001494
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DOI: https://doi.org/10.1038/sj.jhh.1001494
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